Transgender Patients

From the Transgender Day of

Awareness Health Education Initiative
Prepared and sponsored by AMSAs Gender and Sexuality
Committee (www.amsa.org/gender)
 Basic Terminology
Sex- Categorizes people as male, female, or
intersex based on physical attributes: their
genitalia and chromosomes

Gender- A persons feeling or sense of being

male or female. Can also include feeling
neither male nor female, or both.
 Who are Transpeople?
Transpeople are people who for various
reasons identify with a gender that
differs from the sex they were assigned
at birth
Being Transgender
may change ones mannerisms and dress
may motivate one to change their bodies
to reflect their gender identity
Hormone therapy and surgery are
two ways that people alter their bodies
 What does Hormonal Therapy do?
Common Effects of Common Effects of
Testosterone Estrogen, Progesterone
and anti-androgens
Muscle growth Fat redistribution
Fat redistribution Breast enlargement
Deeper voice Smoother skin
Body hair growth Lowered fertility
Male-pattern baldness Lowered libido

All hormonal therapies have side effects

What is Sexual Reassignment Surgery?
When the body of a person, especially their
genitals, is changed to reflect their gender
Common male-to-female surgeries:
Vaginoplasty- creation of a vagina
Breast augmentation
Tracheal shave reducing the adams apple
Facial feminization surgery
Common female-to-male surgeries:
Top surgery removal of breast tissue
Metoidioplasty- Elongating the clitoris
Phalloplasty - Creating a penis from other flesh (rare)
 Brief Transgender History
1930: First modern vaginoplasty performed in Germany
1941: Premarin (commercial estrogen) becomes the first
hormone available
1976: Rene Richards legal battle establishes that the
U.S. will recognize gender changes
1981: The term Transgender comes into use
1994: DSM-IV published, includes Gender
Identity Disorder
 Reasons to visit a doctor
General Health Concerns
Transpeople get broken legs, cancer, the flu, etc.

Issues Specific to Transgender individuals

To receive hormone therapy, get sexual
reassignment surgery or to deal with its effects
 Health Disparities
Transgender people are disproportionately affected by:
1.Physical and Sexual Violence
2.HIV
3.Substance Abuse
4.Suicidal ideation and attempt
5.Lack of health insurance or coverage
6.Sex Reassignment Complications
Why?
 Anatomical Concerns
Whatever the gender
presentation of the
patient, all screenings
should examine the
organs present.

Sensitivity is important
- This may be a difficult experience for some people. For
instance, pelvic exams may be distressing for someone
who is female-to-male
 Comfort
If patients feel unsafe or defensive, they may
not share useful information, such as:
Transgender status
Medications (for instance, hormones)
Symptoms, even important ones
Stress slows wound healing and inhibits
immune function
Stress also can make transpeople less willing
to seek medical help
 Your Mood: Reasons for Discomfort
Well-meaning, but uneducated?
Patients may think that they have to translate
their symptoms into terms you would understand
Hostile?
Patients can detect this and may attempt to
protect themselves by not being truthful. Try to
find another doctor to treat them, or establish
your own professionalism
 Basic Comfort Considerations
Avoid generalizations and assumptions
Ask questions if you are unsure about something
Make every attempt to use correct pronouns:
the ones they use for themselves
If you do not know which pronoun to use, ask which
they prefer.
If you do use an incorrect pronoun, apologize, but do
not make a big deal of it.
 Comfort though Paperwork
Instead of the traditional Male
or Female? question, include
transgender as an option, or
use Gender: ______.
Inquire about a persons partner rather than their
husband or wife.

These questions will not only make trans patients

more comfortable, but will get you more accurate
information.
 For Further Information
Transgender Health Resources on AMSAs
Gender and Sexuality Page
Articles by supportive medical professionals
Transgendercare.com
Much more information at:
Vancouver Coastal Health
transhealth.vch.ca
The Fenway Institute LGBT Health Module 7
http://www.fenwayhealth.org/site/PageServer?
pagename=FCHC_ins_fenway_EducPro_modules#7
 Questions?

Additional questions and comments

may be directed to:

Anthony Rust - arust@calpoly.edu

Premedical Representative
Gender and Sexuality Committee